Development of a Set of Nomograms to Predict Acute Lower Gastrointestinal Toxicity for Prostate Cancer 3D-CRT
- Prostate Programme, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano (Italy)
- Department of Medical Physics, Ospedale San Raffaele, Milano (Italy)
- Department of Radiotherapy, Ospedale Santa Chiara, Trento (Italy)
- Department of Radiotherapy, Ospedale di Circolo, Varese (Italy)
- Department of Medical Physics, Ospedale Villa Maria Cecilia, Lugo (Italy)
- Department of Medical Physics, Ospedale di Circolo, Varese (Italy)
- Department of Radiotherapy, Ospedale Sant' Anna, Como (Italy)
- Division of Radiation Oncology, University of Magna Graecia, Catanzaro (Italy)
- Department of Radiotherapy, Ospedale Villa Maria Cecilia, Lugo (Italy)
- Department of Medical Physics, Ospedale Sant' Anna, Como (Italy)
- Department of Radiotherapy, Istituto per la Ricerca e la Cura del Cancro, Candiolo (Italy)
- Department of Medical Physics, Istituto per la Ricerca e la Cura del Cancro, Candiolo (Italy)
- Department of Radiotherapy, Ospedale SS. Antonio e Biagio, Alessandria (Italy)
Purpose: To predict acute Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) and Subjective Objective Signs Management and Analysis/Late Effect of Normal Tissue (SOMA/LENT) toxicities of the lower gastrointestinal (LGI) syndrome in patients with prostate cancer undergoing three-dimensional conformal radiotherapy using a tool (nomogram) that takes into account clinical and dosimetric variables that proved to be significant in the Italian Association for Radiation Oncology (AIRO) Group on Prostate Cancer (AIROPROS) 0102 trial. Methods and Materials: Acute rectal toxicity was scored in 1,132 patients by using both the RTOG/EORTC scoring system and a 10-item self-assessed questionnaire. Correlation between clinical variables/dose-volume histogram constraints and rectal toxicity was investigated by means of multivariate logistic analyses. Multivariate logistic analyses results were used to create nomograms predicting the symptoms of acute LGI syndrome. Results: Mean rectal dose was a strong predictor of Grade 2-3 RTOG/EORTC acute LGI toxicity (p 0.0004; odds ratio (OR) = 1.035), together with hemorrhoids (p = 0.02; OR 1.51), use of anticoagulants/antiaggregants (p = 0.02; OR = 0.63), and androgen deprivation (AD) (p = 0.04; OR = 0.65). Diabetes (p = 0.34; OR 1.28) and pelvic node irradiation (p = 0.11; OR = 1.56) were significant variables to adjust toxicity prediction. Bleeding was related to hemorrhoids (p = 0.02; OR = 173), AD (p = 0.17; OR = 0.67), and mean rectal dose (p 0.009; OR = 1.024). Stool frequency was related to seminal vesicle irradiation (p = 0.07; OR = 6.46), AD administered for more than 3 months (p = 0.002; OR = 0.32), and the percent volume of rectum receiving more than 60 Gy (V60Gy) V60 (p = 0.02; OR = 1.02). Severe fecal incontinence depended on seminal vesicle irradiation (p = 0.14; OR = 4.5) and V70 (p = 0.033; OR 1.029). Conclusions: To the best of our knowledge, this work presents the first set of nomograms available in the literature specific to symptoms of LGI syndrome and provides clinicians with a tailored probability of the specific outcome. Validation of the tool is in progress.
- OSTI ID:
- 21124352
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 71, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2007.11.037; PII: S0360-3016(07)04604-4; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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